How much rates vary
Facilitymedian $1,413 · 10th to 90th $347 to $3,715Professionalmedian $1,950 · 10th to 90th $1,096 to $7,762
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,096.48 | $1,412.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $323.59 Median $1,000.00 Typical High $3,890.45 | Facility | None | $323.59 | $1,000.00 | $3,890.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $7,762.47 | Professional | None | $1,258.93 | $3,235.94 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $741.31 Typical High $1,000.00 | Facility | None | $50.12 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Fallon Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,454.71 | Facility | None | $1,288.25 | $1,584.89 | $2,454.71 |
Fallon Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,659.59 | $2,238.72 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,380.38 | $2,630.27 | $3,630.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $323.59 Median $1,000.00 Typical High $3,890.45 | Facility | None | $323.59 | $1,000.00 | $3,890.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $7,762.47 | Professional | None | $1,258.93 | $3,235.94 | $7,762.47 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $4,786.30 | Professional | None | $1,202.26 | $1,621.81 | $4,786.30 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,862.09 | Facility | None | $912.01 | $1,230.27 | $1,862.09 |
Well Sense Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,071.52 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,000.00 |
Where Massachusetts sits
The same service costs 16.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 9th of 51
$1,905
AK $3,090TX $191
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.